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Dr. Andrew Rynne

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Sudden ringing in ear. Hearing test showed mild sensory hearing loss. Any suggestion?

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Dr. Sumit Bhatti

ENT Specialist

Practicing since :1991

Answered : 2563 Questions

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Posted on Fri, 28 Dec 2012 in Ear, Nose and Throat Problems
Question: Sudden ringing in right ear over one month and ear feels full. Tried decongestant no help. Tried steroid treatment, no help. Went to ENT yesterday hearing test showed mild sensory hearing loss compared to left ear. Dr. ENT said nothing they can do, probably a virus and may or may not resolve. I have not been sick and worried that he should have ordered MRI. Should I get 2nd opinion or wait it out?
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Answered by Dr. Sumit Bhatti 55 minutes later
Hi,

Thank you for your query.

1. I am assuming that:
a. You ear drums are normal and your PTA (Pure Tone Audiogram) and Impedance Audiogram (Tympanometry) is normal (no middle ear problems or ear infection as your ears are feeling clogged). There is no ear wax. This is one of the most common causes of tinnitus.
b. You have do not have pulsatile tinnitus.
c. Your blood pressure is within normal limits.
d. There is no vertigo or dizziness.
e. You do not have anemia, thyroid problems.
f. You did not have any major febrile illness, exposure to loud sounds, trauma to the ear or strenuous exercise recently.
g. There is no NIHL (Noise Induced Hearing Loss).

2. You have been investigated as per your age for example, atherosclerosis, cervical spondylosis and so on.

3. Your PTA (Pure Tone Audiogram) shows mild sensorineural hearing loss. The normal course of treatment provided for SSHL in a non diabetic is high dose steroids. Since you have already tried steroids, what was the dose? It may have to be increased if it is SSNHL. Other medication includes anti-virals, blood thinning agent, rheologic or blood flow improvement, neural tonics, Carbogen (vasodilator) and Hyperbaric Oxygen Therapy (HBOT), if available. The alternative treatment is transtympanic (intratympanic) steroids. If your PTA shows more than 20-30 dB hearing loss in three contiguous frequencies then it is defined as Sudden Sensori-Neural Hearing Loss (SSNHL). SSNHL is a medical emergency. The therapeutic window is 4-6 weeks for optimal results.

4. MRI Scans are usually normal. They help rule out rarer causes.

5. You may share your audiograms, investigations and progress reports here for more specific treatment and rehabilitation options.

I must emphasize that in a vast majority of patients of tinnitus, the cause is never found. However there are further treatment options.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumit Bhatti 1 hour later
you are correct in assumptions 1, a-g. Just to be clear tinnitus is not the chief complaint. The biggest problem is the decreased hearing. The tinnitus is along with it. It is especially worse in large areas. My audiogram did show that the right ear starts the same hearing as right and then drops around 20 db and then at the end meets up again with the left. Is tinnitus a result of the hearing loss?
doctor
Answered by Dr. Sumit Bhatti 1 hour later
Hi,

Thank you for writing back.

1. The tinnitus is most likely due to your hearing loss.

2. Your audiogram seems to look like a mild 'cookie bite' audiogram.

3. Causes of "cookie-bite" hearing loss include chronic exposure to loud noises, presbycusis (Age related), genetic (congenital) predisposition, and drug induced hearing loss. Does any other member of your family have a hearing loss?

4. Kindly follow the above mentioned guidelines.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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